Unity Health Insurance* | Elite Silver 40/90 Value

Elite Silver 40/90 Value is an Obamacare health insurance plan offered by Unity Health Insurance* that is available for individuals and families.

This plan is a HMO, meaning you will have to stay within the insurance company’s network, and will need to see a primary care doctor first and get a referral in order to see a specialist. (Read more about HMOs.)

This plan is a Silver metal level plan, which generally has a mid-level monthly cost and deductible (and co-pay), and provides middle-of-the-road insurance coverage for people who occasionally use their health care benefits (doctors, prescription drugs, etc.).

Deductible amount of $4,350. A deductible is the amount of healthcare costs you will pay on your own each year before the insurance company.

Max out-of-pocket of $7,100, which is the most you will pay in a plan year outside of premiums, out-of-network providers and non-essential health benefits.

Who is this plan for?

This plan with a moderate monthly cost is great for individuals and families who occasionally visit the doctor or use prescription drugs. The very high deductible on this plan means you will pay a significant amount of money of pocket for medical care and prescriptions before your insurance kicks in. The very high out-of-pocket maximum on this plan means you could be faced with a very expensive medical bill if an emergency happens. Plans with this type of provider network tend to have a narrower provider network.

HealthCare.com is a privately-held website for healthcare consumers operating since 2007. We’re not the government marketplace.

Highlights

Emergency Room:

$350

Retail Drugs:

$50

Generic Drugs:

$10

Overview

Plan Type:

HMO

Metal Level:

Silver

Health Spending Account:

No

Primary Care Office Visit:

$40

Specialist Office Visit:

$90

Out of Network Coverage:

No

Out of Country Coverage:

No

Coverage Details

Preventive Care

Periodic Health Exam

In Network:

No Charge after deductible

Out of Network:

Not Covered

Well Baby Care

In Network:

No Charge after deductible

Out of Network:

Not Covered

Inpatient

Hospital Services

In Network:

10% Coinsurance after deductible

Out of Network:

Not Covered

Physician Fee

In Network:

10% Coinsurance after deductible

Out of Network:

Not Covered

Skilled Nursing Facility

In Network:

10% Coinsurance after deductible

Out of Network:

Not Covered

Mental Health

In Network:

10% Coinsurance after deductible

Out of Network:

Not Covered

Substance Abuse

In Network:

10% Coinsurance after deductible

Out of Network:

Not Covered

Home Healthcare

In Network:

10% Coinsurance after deductible

Out of Network:

Not Covered

Outpatient

Surgery

In Network:

10% Coinsurance after deductible

Out of Network:

Not Covered

X-ray and Diagnostics

In Network:

10% Coinsurance after deductible

Out of Network:

Not Covered

Labs

In Network:

10% Coinsurance after deductible

Out of Network:

Not Covered

Facility Fee

In Network:

10% Coinsurance after deductible

Out of Network:

Not Covered

Mental Health

In Network:

$40

Out of Network:

Not Covered

Substance Abuse

In Network:

$40

Out of Network:

Not Covered

Rehabilitation Services

In Network:

10% Coinsurance after deductible

Out of Network:

Not Covered

Maternity/Pregnancy

Pre & Postnatal Care

In Network:

$40

Out of Network:

Not Covered

Labor and Delivery Inpatient Services

In Network:

10% Coinsurance after deductible

Out of Network:

Not Covered

Dental

Accidental Care

In Network:

10% Coinsurance after deductible

Out of Network:

Not Covered

Vision

Eye Exam (Child)

In Network:

No Charge after deductible

Out of Network:

Not Covered

Glasses (Child)

In Network:

10% Coinsurance after deductible

Out of Network:

Not Covered

Additional Coverage

Chiropractic Care

In Network:

$40

Out of Network:

Not Covered

Habilitation Services

In Network:

10% Coinsurance after deductible

Out of Network:

Not Covered

Rehabilitation Services (Speech)

In Network:

10% Coinsurance after deductible

Out of Network:

Not Covered

Rehabilitation Services (Occupational Therapy)

In Network:

10% Coinsurance after deductible

Out of Network:

Not Covered

Hospice Service

In Network:

10% Coinsurance after deductible

Out of Network:

Not Covered

Diabetes Care Management

In Network:

10% Coinsurance after deductible

Out of Network:

Not Covered

Durable Medical Equipment

In Network:

10% Coinsurance after deductible

Out of Network:

Not Covered

Hearing Aids

In Network:

10% Coinsurance after deductible

Out of Network:

Not Covered

Nutritional Consuleling

In Network:

$40

Out of Network:

Not Covered

Reconstructive Surgery

In Network:

10% Coinsurance after deductible

Out of Network:

Not Covered

Doctor Visits

Primary Care Visit

In Network:

$40

Out of Network:

Not Covered

Specialist Visit

In Network:

$90

Out of Network:

Not Covered

Other Practitioner Office Visit

In Network:

$40

Out of Network:

Not Covered

Preventative Care / Screening / Immunization

In Network:

No Charge after deductible

Out of Network:

Not Covered

Emergency Room and Urgent Care

Emergency Room Services

In Network:

$350

Out of Network:

$350

Urgent Care Services

In Network:

$90

Out of Network:

$90

Ambulance/Transportation Services

In Network:

10% Coinsurance after deductible

Out of Network:

10% Coinsurance after deductible

Drugs

Generic Prescription

In Network:

$10

Out of Network:

$10

Retail Brand Drugs

In Network:

$50

Out of Network:

$50

Non Retail Brand Drugs

In Network:

$100

Out of Network:

$100

Specialty Drugs

In Network:

$400

Out of Network:

$400

Drug Deductible

In Network:

Individual: No Charge Family: No Charge

Out of Network:

Individual: Not Applicable Family: Not Applicable

Additional Plan Information

HealthCare.com is a privately owned website, and monthly costs shown above are estimates only.
Your monthly premium may change based on the data provided, outside fees, optional benefits
or if other factors take effect before your coverage start date. Note that insurance companies
reserve the right to change your premium rate and the policy terms at any time. Effective date,
benefit amounts and other conditions may apply at the discretion of the insurance carrier you select.
Depending on your state of residence, this website may not display all plans available by state.
The Obamacare Tax Subsidy Calculator amounts are estimates only and the actual amount of subsidy
eligibility may differ. Access to your physician depends on network selected, and networks can
change without notice. Contact your health insurance company to confirm your healthcare provider
is still available in the network you select.